Surgical approach to medullary thyroid carcinoma associated with multiple endocrine neoplasia type 2

We briefly review the surgical approaches to medullary thyroid carcinoma associated with multiple endocrine neoplasia type 2 (medullary thyroid carcinoma/multiple endocrine neoplasia type 2). The recommended surgical approaches are usually based on the age of the affected carrier/patient, tumor staging and the specific rearranged during transfection codon mutation. We have focused mainly on young children with no apparent disease who are carrying a germline rearranged during transfection mutation. Successful management of medullary thyroid carcinoma in these cases depends on early diagnosis and treatment. Total thyroidectomy should be performed before 6 months of age in infants carrying the rearranged during transfection 918 codon mutation, by the age of 3 years in rearranged during transfection 634 mutation carriers, at 5 years of age in carriers with level 3 risk rearranged during transfection mutations, and by the age of 10 years in level 4 risk rearranged during transfection mutations. Patients with thyroid tumor >5 mm detected by ultrasound, and basal calcitonin levels >40 pg/ml, frequently have cervical and upper mediastinal lymph node metastasis. In the latter patients, total thyroidectomy should be complemented by extensive lymph node dissection. Also, we briefly review our data from a large familial medullary thyroid carcinoma genealogy harboring a germline rearranged during transfection Cys620Arg mutation. All 14 screened carriers of the rearranged during transfection Cys620Arg mutation who underwent total thyroidectomy before the age of 12 years presented persistently undetectable serum levels of calcitonin (<2 pg/ml) during the follow-up period of 2–6 years. Although it is recommended that preventive total thyroidectomy in rearranged during transfection codon 620 mutation carriers is performed before the age of 5 years, in this particular family the surgical intervention performed before the age of 12 years led to an apparent biochemical cure

Urinary Monocyte Chemoattractant Protein-1 Levels and Interstitial Changes in the Renal Cortex and Their Relationship with Loss of Renal Function in Renal Transplant Patients with Delayed Graft Function

Background: Inflammatory cell infiltration and residual areas of fibrosis in kidneys after renal transplantation can lead to functional abnormalities with long-term implications. Objectives: The aim of this study was to determine urinary monocyte chemoattractant protein-1 (uMCP-1) levels, relative cortical interstitial area (RCIA), and cortical tubulointerstitial macrophage infiltration in renal transplant patients with delayed graft function (DGF) and their possible correlation with graft outcome. Design: Patients were followed after biopsies for one year, and their renal function and structure were evaluated, as well as parameters of inflammatory process. Setting: Clinical Hospital of the School of Medicine of Ribeirão Preto. Patients: Twenty-two cadaveric kidney transplant recipients with DGF were followed for one year. Measurements: Renal function, RCIA, macrophages infiltration and uMCP-1 levels were evaluated. Methods: Renal function was evaluated by plasma creatinine levels. RCIA was determined by morphometry. Immunohistochemical staining of macrophages was performed using an anti-CD68 monoclonal antibody. uMCP-1 levels were determined using a human MCP-1/CCL2 immunoassay kit. Results: There was a significant increase in uMCP-1 levels in transplant patients compared with controls ( p < 0.001). RCIA was 7.1% (6.4 to 9.2; median and 25th to 75th percentiles) in controls and 37.1% (28.1 to 43.7) in patients with kidney transplants ( p < 0.001). The patients who presented with a higher RCIA in the first biopsy showed higher levels of plasma creatinine one year after transplantation (r = 0.44; p < 0.05). The number of tubulointerstitial macrophages per 0.10 mm 2 grid field was higher in the renal cortex of transplant patients compared with the controls (19.4 (9.0 to 47.1) vs. 2.5 (1.8 to 3.4), p < 0.001). There was also a positive correlation between the RCIA and the number of tubulointerstitial macrophages in the renal cortex of these patients (r = 0.49; p < 0.001). Limitations: The number of patients studied was relatively small and may not be reflecting outcomes over a larger spectrum of kidney cadaveric transplants. Conclusions: Our results demonstrate increased levels of uMCP-1 in transplant patients with DGF, in addition to increased tubulointerstitial macrophage infiltration and RCIA, which could predict the outcome of renal function in these patients

Bright nanoparticles for an even brighter future: efficient production of luminescent carbon nanodots from olive mill wastewater

Este trabalho foi financiado pelo Concurso Anual para Projetos de Investigação, Desenvolvimento, Inovação e Criação Artística (IDI&CA) 2016 do Instituto Politécnico de Lisboa. Código de referência IPL/2016/NANOLIVE/ISELCarbon nanodots (CNDs) are a very recent class of spherical-shaped nanosized carbon materials possessing average typical diameters < 10 nm. Since the very first reports on carbon dots,1,2 a variety of methods (top-down and bottom-up strategies), carbon sources and passivating agents, have dealt with their synthesis.3 The bottom-up approach, encompassing the use of pyrolytic/solvothermal processes, is more amenable for large-scale production and can cope with a large diversity of carbon precursors, either from natural or synthetic sources, typically endowed with acid, alcohol and amine functionalities.4 Some of the interesting CNDs properties include tunable photoluminescence, outstanding photostability and negligible cytotoxicity. These unique properties have prompted their intense and widespread use in several fields, such as fluorescent bioimaging and nanomedicine, chemo/biosensing, photocatalysis and optoelectronics.4info:eu-repo/semantics/publishedVersio

Serum sclerostin is an independent predictor of mortality in hemodialysis patients

Background\ud Sclerostin (Scl) has recently emerged as a novel marker of bone remodeling and vascular calcification. However, whether high circulating Scl is also a risk factor for death is not well established. The purpose of this study was to test whether serum Scl would be associated with mortality.\ud \ud \ud Methods\ud we measured serum Scl in a hemodialysis patients’ cohort, which was followed during a ten-year period. Competing risk regression models were applied, as during the follow-up, patients were exposed to both events kidney transplant and death.\ud \ud \ud Results\ud Ninety-one patients aged 42.3 ± 18.8 years (55% of male gender, 15% of diabetes) were included. During the follow-up, 32 patients underwent kidney transplant and 26 patients died. Non-survivals presented higher FGF23, higher Scl and lower creatinine. There was an association between all-cause mortality and higher Scl (HR = 2.2), higher age (HR = 1.04) and presence of diabetes (HR = 2.27), by competing risk analyses. Even including potential markers of mortality, as creatinine, FGF 23, and gender, Scl, age and diabetes remained significantly related to higher mortality.\ud \ud \ud Conclusion\ud Serum Scl is an independent predictor of mortality in dialysis patients. However, whether clinical interventions to modulate Scl would be able to improve these patients survival needs to be determined.Fapes

Electronic and optical properties of lead iodide

ABSTRACT: Lead iodide (PbI2) is a very important material with a technological applicability as a room-temperature radiation detector. It is a wide-band-gap semiconductor (Eg.2 eV) with high environmental stability efficiency. The performance of the detector cannot be fully understood unless its electronic and optical properties are determined. Recently, its band-gap energy and thermal properties were determined by photoacoustic spectroscopy. A single crystal of PbI2 was grown by the Bridgman method with the c-axis oriented perpendicular to the growth axis. The purpose of this work is to obtain the electronic structure of PbI2, its dielectric functions e 1 and e 2 by ellipsometry and theoretically by full-potential linear muffin-tinorbital ~FPLMTO! method, and the temperature dependence of the measured band-gap energy by optica absorption. The obtained Eg(T) can be fitted by two different methods, leading to Eg ~0 K! and Eg ~300 K!

Reliability and validity study of Persian modified version of MUSIC (musculoskeletal intervention center) – Norrtalje questionnaire

<p>Abstract</p> <p>Background</p> <p>Musculoskeletal disorders (MSDs) are a major health problem in the world. Self-reported questionnaires are a known method for estimating the prevalence of MSDs among the population. One of the studies concerning MSDs and their relation to work-related physical and psychosocial factors, as well as non-work-related factors, is the MUSIC-Norrtalje study in Sweden. In this study, the research group developed a questionnaire, which has been validated during its development process and is now considered a well-known instrument. The aim of this study is to validate the Persian version of this questionnaire.</p> <p>Methods</p> <p>The first step was to establish two expert panel groups in Iran and Sweden. The Focus Group Discussion (FGD) method was used to detect questionnaire face and content validity. To detect questionnaire reliability, we used the test-retest method.</p> <p>Results</p> <p>Except for two items, all other questions that respondents had problems with in the focus group (20 of 297), had unclear translations; the ambiguity was related to the stem of the questions and the predicted answers were clear for the participants. The concepts of 'household/spare time' and 'physical activity in the workplace' were not understood by the participants of FGD; this has been solved by adding further descriptions to these phrases in the translation. In the test-retest study, the reliability coefficient was relatively high in most items (only 5 items out of 297 had an ICC or kappa below 0.7).</p> <p>Conclusion</p> <p>The findings from the present study provide evidence that the Persian version of the MUSIC questionnaire is a reliable and valid instrument.</p

SafeFit Trial: Virtual clinics to deliver a multimodal intervention to improve psychological and physical wellbeing in people with cancer. Protocol of a COVID-19 targeted non-randomised phase III trial

Introduction: The impact of the COVID-19 pandemic (caused by the SArS-CoV-2 virus), on individuals with cancer has been profound. It has led to increased anxiety, distress and deconditioning due to reduced physical activity. We aim to investigate whether SafeFit; a multi-modal intervention of physical activity, nutrition and psychological support delivered virtually by cancer exercise specialists (CES) can improve physical and emotional functioning during the COVID-19 pandemic.Methods and analysis: A phase III non-randomised intervention trial, target recruitment of 1050 adults with suspected or confirmed diagnosis of cancer. All recruited participants will receive the multimodal intervention delivered by CES for six months. Sessions will be delivered 1-to-1 using telephone/video conferencing consultations. CES will work with each participant to devise a personalised programme of 1) physical activity, 2) basic dietary advice and 3) psychological support, all underpinned by a behaviour change intervention.Primary outcome: Physical and emotional functioning as measured by the EORTC-QLQ-C30. Secondary outcomes: Overall quality of life measured by EORTC-QLQ-C30 and EQ-5D-5L, health economics, patient activation, self-efficacy to self-manage chronic disease, distress, Impact of Covid-19 on emotional functioning, self-reported physical activity, functional capacity and nutrition. Adherence to the intervention will also be measured and a process evaluation conducted. Ethics and dissemination: Ethical approval was obtained from the Health Research Authority (reference number: 20/NW/0254). Results of this trial will be disseminated through publication of peer reviewed articles, presentations at scientific conferences and to the public and people with cancer in collaboration with our patient and public involvement representatives and partners. Trial registration: NCT0442561